Management Of Health Care Services Research Articles

A robust algorithm for authenticated health data access via blockchain and cloud computing.

In modern healthcare, providers increasingly use cloud services to store and share electronic medical records. However, traditional cloud hosting, which depends on intermediaries, poses risks to privacy and security, including inadequate control over access, data auditing, and tracking data origins. Additionally, current schemes face significant limitations such as scalability concerns, high computational overhead, practical implementation challenges, and issues with interoperability and data standardization. Unauthorized data access by cloud providers further exacerbates these concerns. Blockchain technology, known for its secure and decentralized nature, offers a solution by enabling secure data auditing in sharing systems. This research integrates blockchain into healthcare for efficient record management. We proposed a blockchain-based method for secure EHR management and integrated Ciphertext-Policy Attribute-Based Encryption (CP-ABE) for fine-grained access control. The proposed algorithm combines blockchain and smart contracts with a cloud-based healthcare Service Management System (SMS) to ensure secure and accessible EHRs. Smart contracts automate key management, encryption, and decryption processes, enhancing data security and integrity. The blockchain ledger authenticates data transactions, while the cloud provides scalability. The SMS manages access requests, enhancing resource allocation and response times. A dual authentication system confirms patient keys before granting data access, with failed attempts leading to access revocation and incident logging. Our analyses show that this algorithm significantly improves the security and efficiency of health data exchanges. By combining blockchain's decentralized structure with the cloud's scalability, this approach significantly improves EHR security protocols in modern healthcare setting.

ICT Effect on India's Healthcare Management Services Development

In today's healthcare services, information and communication technology is no longer only employed to automate procedures. Rather, Information Communication Technology is being utilized as a significant system for offering kinds of help to individuals. The execution of ICT in the clinical benefits region enjoys accomplished different benefits, such as enhanced revenue, effectiveness, efficacy, faster service, customer satisfaction, ease for customers, flexibility in operation, continuously operations, capacity money saved, and expense benefits. ICT has been used in the healthcare industry in many creative ways that have improved communication between physicians, patients, and other stakeholders. This can be accomplished by enlisting the aid of social entrepreneurs to help create a wealth opportunity. The researcher's goal in this study is to evaluate how widely ICT is being used in India's various health fields. It is additionally considered critical to identify and evaluate the technology in the medical services area to recommend appropriate proactive, protecting, and advancing methodologies that would improve the authenticity and viability of medical services offices in India

Factors affecting Implementation of Primary Health Care Services among Nurses in Level 3 Health Facilities in Kiambu County, Kenya

Primary health care is instrumental to delivery of quality basic health care services in communities. Its significance lies in ensuring that appropriate basic healthcare services are offered to all who need them competently, fairly and efficiently based on a people-centered approach. The study therefore sought to assess the factors affecting implementation of primary health care services among nurses in level 3 health facilities in Kiambu County, Kenya. This was an analytical cross-sectional study conducted among 141 nurses who worked in level 3 health facilities in Kiambu County and recruited using simple random sampling technique. They responded to a self-administered questionnaire. Data was probed descriptively with measures including proportions along with counts utilizing SPSS version 25.0. Relationships in study attributes were probed with chi-square test at 95% CI with outcomes shown in tables and figures. From the findings, majority (91.5%, n = 129) of the nurses rated the level of implementation of primary health care services in their work stations as sub-optimal. The factors found to strongly correlate with the poor implementation of the primary health care services were inadequate number of available healthcare personnel (p = 0.002); poor or low remuneration of health care providers (p = < 0.000); poor supply of essential medicine/drugs (p = 0.011); unavailability of essential medical equipment (p = 0.000); poor planning of the PHC programs (p = 0.024); lack of or inadequate support to HCPs from the hospital management (p = 0.013) and significant underfunding of the primary health care services (p = 0.001). Efforts are therefore required on the part of relevant stakeholders in Kiambu County to address the various factors that impede effective delivery of primary health care services

ANDROID HEALTHCARE APPLICATION

The healthcare systems is pivotal in improving the accessibility and management of healthcare services. This paper focuses on the creation of a comprehensive appointment management system to streamline various healthcare interactions. Modern healthcare challenges such as scheduling appointments, ordering medications, and accessing health information necessitate an integrated approach. The proposed system includes modules for user registration, lab test management, medication management, doctor search and appointment booking, health education articles, order tracking, and user logout functionalities. Utilizing user-friendly interfaces and robust backend infrastructure, the system ensures secure user registration, easy browsing of lab tests and medications, efficient search for specialist doctors, convenient appointment booking, access to health articles, and order tracking. Key features include personalized user profiles, real-time appointment scheduling, and secure data storage using a SQLite database. Keywords: Healthcare management, Mobile Applications, Software Engineering

Reflections of nurses and primary healthcare managers on integrating hospital at home into public primary healthcare services: a Norwegian focus group study

Background Hospital at home (HaH) is an innovative approach to healthcare delivery that brings specialized services to patients’ homes. HaH services are typically available in urban areas where hospitals can easily reach nearby patients. An integrated care model that utilizes the public primary healthcare system may extend HaH services to include patients residing further away from hospitals. However, there is limited evidence of primary healthcare employees’ views on integrating HaH care into primary healthcare services. This study aimed to explore the reflections of primary healthcare employees on integrating HaH care into primary healthcare services. Methods Ten focus group interviews were conducted with homecare nurses and managers of primary healthcare services in five municipalities in Mid-Norway. Reflexive thematic analysis was used to analyze the data. Results The analysis resulted in three key themes regarding the integration of HaH care into primary healthcare. Participants discussed how they capture the distinctiveness of HaH care within the primary healthcare landscape. Moreover, they identified that the introduction of HaH care reveals opportunities to address challenges. Lastly, the study uncovered a strong primary healthcare commitment and a sense of professional pride among the participants. This resilience and dedication among primary healthcare employees appeared as an incentive to make the integration of HaH work. Conclusions This study offers valuable insights into integrating HaH into primary healthcare services, highlighting opportunities to address challenges. The resilience and dedication of primary healthcare employees underscore their commitment to adapting to and thriving with HaH care. To establish a sustainable HaH care model, it is important to address geographical limitations, consider the strain on providers, maintain robust relationships, enhance funding, and formalize decision-making processes.

Social health organizations: an analysis of the specialties and exams contracted by the State of São Paulo, Brazil.

Social Health Organizations (SHOs) are private entities that receive resources from governments for the management of public healthcare services. With the history of market interest in public health and the high volume of resources transferred to SHOs, one must question if the market logic continues to be inserted in this management model. The understanding of the dynamics of providing healthcare services to the population in the different contracts may help to understand how possible changes in the contracted services may have an influence. This is a descriptive-exploratory study using quantitative and qualitative approaches. Documental research was conducted through the collection of data from management contracts and amendments. The State of São Paulo was chosen because of its economic representativeness and for being the pioneer state in the implementation of SUS services managed by SHO. Medical specialties were included in 184 renegotiations (6.14%) and excluded in 187 (6.24%), whereas non-medical services were included in 26 renegotiations (2.97%) and excluded in 144 (16.44%). Regarding examinations, 101 renegotiations (18.07%) had their goals increased and 60 (10.73%) reduced, while 6 renegotiations (1.07%) included exams and 12 (2.14%) excluded them.

Organizações sociais de saúde: análise sobre as especialidades e exames contratados pelo Estado de São Paulo, Brasil

Abstract Social Health Organizations (SHOs) are private entities that receive resources from governments for the management of public healthcare services. With the history of market interest in public health and the high volume of resources transferred to SHOs, one must question if the market logic continues to be inserted in this management model. The understanding of the dynamics of providing healthcare services to the population in the different contracts may help to understand how possible changes in the contracted services may have an influence. This is a descriptive-exploratory study using quantitative and qualitative approaches. Documental research was conducted through the collection of data from management contracts and amendments. The State of São Paulo was chosen because of its economic representativeness and for being the pioneer state in the implementation of SUS services managed by SHO. Medical specialties were included in 184 renegotiations (6.14%) and excluded in 187 (6.24%), whereas non-medical services were included in 26 renegotiations (2.97%) and excluded in 144 (16.44%). Regarding examinations, 101 renegotiations (18.07%) had their goals increased and 60 (10.73%) reduced, while 6 renegotiations (1.07%) included exams and 12 (2.14%) excluded them.

Lessons for tomorrow: The role of relationships and mindfulness in sustaining services during a crisis.

The COVID-19 pandemic placed unprecedented demands on hospitals around the globe, making timely crisis response critical for organizational success. One mechanism that has played an effective role in health care service management during large-scale crises is the Hospital Incident Command System. The aim of this article was to understand the role of HICS in the management of a large academic medical center and its impact on relationships and communication among providers in the delivery of services during a crisis. This mixed methods study was based on meeting observations, document reviews, semistructured interviews, and two measures of team performance within an academic medical center in the Northeast during the COVID-19 pandemic. Descriptive and bivariate analyses were applied, and qualitative data were coded and analyzed for themes. HICS provided a systematic information-sharing and decision-making process that increased communication and coordination among team members. Analyses indicate a correlation between dimensions of relational coordination and organizational mindfulness. Qualitative data revealed the importance of shared meetings and huddles and the evolution of HICS across multiple waves of the crisis. HICS facilitated organizational improvements during the crisis response and generated opportunities to maintain specific coordination practices beyond the crisis. The prolonged implementation of HICS during the COVID-19 pandemic created challenges, including the disruption of the routine leadership structure. Applying relational coordination and organizational mindfulness frameworks may allow hospitals to leverage communications and relationships within a high-stakes environment to improve service delivery.

Impact of Privatization on Healthcare System: A Systematic Review.

A notable shift in healthcare policy is healthcare privatization, which refers to the transfer of ownership, management, or provision of healthcare services from the public sector to private entities. To provide a narrative examination of the impact of privatization on various dimensions of healthcare, including quality, equity, accessibility, and cost-effectiveness. Policymakers can utilize the findings of this study to make well-informed decisions regarding privatization strategies. A systematic review was implemented using the following databases: PubMed, Scopus, and Google Scholar. Studies conducted from January 2000 to January 2023 in developing or developed countries that assessed the impact of healthcare privatization on population health within public sector institutions were included. Eleven studies were included. The findings revealed diverse perspectives on the impact of healthcare privatization, with four studies (36.4%) supporting privatization (two of these were conducted in Saudi Arabia), six studies (54.5%) opposing it (three of these were conducted in European countries), and one study (9.1%) taking a neutral stance. Two studies investigated the impact on healthcare quality, and both revealed that privatization negatively impacts uninsured patients and low-income populations. In addition, five studies investigated the healthcare access and equity dimensions following privatization: one was in favor, one was neutral, and three were opposing it. Four studies investigated the cost-effectiveness dimension, with three in favor and one study opposing it. This review highlights different perspectives on healthcare privatization. While studies, as those from Saudi Arabia, suggest benefits in terms of efficiency and innovation, others, particularly from European countries, emphasize negative consequences such as inequity and reduced quality. This emphasizes the need for more investigations to understand privatization's impact on healthcare.

Use of Health Care Services and Its Associated Factors Among People With Type 2 Diabetes in Nepal.

This study aimed to assess the utilization of health care services and its associated factors among people with type 2 diabetes mellitus (T2DM) in Nepal. Data on the utilization of health care services were assessed in 481 adults aged 30 to 70 years with T2DM in Nepal. Multiple logistic regression analysis was performed to determine the factors associated with the utilization of health care services. Over 6 months, 66.1% of participants visited health care facilities or health service providers, followed by specialist visits (3.5%), hospitalization (2.1%), and emergency department visits (1.9%). Visit to health care facilities was significantly higher among those aged 50 to 59 years old (ORA: 1.64), practicing Hinduism (ORA: 2.4), and earning NRs ≥30 000 (≥USD 226.10) (ORA: 1.82) as compared to those aged ≥60 years old, practicing other religions, and with monthly family income NRs ≤10 000 (≤USD 75.37), respectively. The utilization of health care services among people with T2DM in Nepal was reasonably low. Identifying the underlying causes of low use of health care services is of great importance to bridge the gap in using health care services for management of diabetes.

Measuring and Managing Healthcare Supply and Demand in Real-Time.

Measuring the supply and demand for access to and wait-times for healthcare is key to managing healthcare services and allocating resources appropriately. Yet, few jurisdictions in distributed, socialized medicine settings have any way to do so. In this paper, we propose the requirements for a jurisdictional patient scheduling system that can measure key metrics, such as supply of and demand for regulated health care professional care, access to and wait times for care, real-time health system utilization and provide the data to compute patient journeys. The system is also capable of tracking new supply of providers and who does not have access to a primary care provider. Benefits, limitations and risks of the model are discussed.

Hubungan Bauran Pemasaran dengan Loyalitas Pasien: Literature Review

Introduction: This research explores the relationship between the marketing mix (7Ps) and patient loyalty in the context of healthcare, particularly in outpatient units of hospitals in Indonesia. A deep understanding of factors influencing patient loyalty provides valuable insights for healthcare service managers. Objective: The main objective of this study is to identify and analyze the relationship between marketing mix elements, including product, price, promotion, place, process, people, and physical evidence, with patient loyalty in the hospital environment. The research also aims to provide insights into key factors influencing patients' decisions to revisit healthcare services Method: Using a systematic review approach following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the study conducted searches on Scopus and Google Scholar databases, considering articles published between 2018 and 2023. Twelve articles meeting inclusion criteria were identified and analyzed Result: Research findings indicate a positive correlation between specific elements of the marketing mix and patient loyalty, emphasizing their significance in influencing patients' decisions to reuse healthcare services. Key influencing factors include service performance, responsiveness, adherence to standard timelines, and advertising. Conclusion: The study confirms the importance of specific marketing mix elements in shaping patient loyalty in hospitals. Location, promotion, personnel, and physical evidence emerge as key elements for hospitals to focus on in enhancing patient loyalty. Practical recommendations are provided as guidance for hospital managers to improve these aspects and enhance the overall patient experience.

Digital Healthcare: Requirements for a Successful Transformation

Digital transformation of healthcare is the dominating discussion topic for all healthcare stakeholders. Digital transformation encompasses all areas of healthcare and is far more than digital healthcare applications (DiGA), digital care applications (DiPA), telemedicine applications, telematics infrastructure activities, and applications from the fields of eHealth, mHealth, or Telehealth. All existing care processes and structures in the healthcare system are undergoing an inventory in order to transfer analog components of care into a digital context. The digital transformation is not taking place exclusively in economic sectors such as healthcare, but is a process of change throughout society in the collection, use, provision, linking and evaluation of information (=data). For the healthcare sector, it is clear that different technical concepts are used, while digital healthcare takes place in different places and at different times, may include different user (groups) and retains, expands or changes the healthcare context. Established healthcare functions such as diagnostics, therapy, documentation and the management of healthcare services are retained and transferred to a digital context. In addition, new application areas will emerge, such as the overarching access to health data by different actors, real-time-driven monitoring systems of holistic health data, (clinical) decision systems, or the provision of data for health services. Even if the majority of the digital transformation has not yet taken place, it is assumed that these functions and application areas of healthcare will serve to sustainably improve the quality of care and benefit the well-being of all (future) patients. For the transfer of existing processes into a digital context and the establishment of new application areas, there are prerequisites for healthcare institutions and the healthcare system itself.

Clinical Leadership in Managing Healthcare Services - A Surgeon’s View Point

Clinical Leadership in Managing Healthcare Services - A Surgeon’s View Point

Intelligence and Its Impact on Society

he present study aims to investigate the phenomenon under examination in a comprehensive and systematic manner. The This article discusses the utilization of artificial intelligence across many industries and its impacts on society, encompassing both advantageous and disadvantageous aspects. Artificial intelligence (AI) plays a significant role in the healthcare sector by aiding in the management of healthcare services, facilitating early diagnosis, enhancing documentation processes, and enabling robotic surgery. Artificial intelligence (AI) in the realm of education offers sophisticated instructional methodologies to students through the utilization of data mining techniques, intelligent teaching platforms, and personalized learning systems. The positive outcomes of artificial intelligence include enhanced productivity, amplified revenue generation, employment creation, and mitigation of human mistakes. Artificial intelligence (AI) engenders both advantageous and detrimental consequences. The adverse consequences of artificial intelligence encompass workforce downsizing, labor market contractions, concerns regarding privacy protection, and disparities. Hence, it is imperative that the development of artificial intelligence adheres to ethical principles and serves as an asset to society.

Rescuing Masked Doctor-Patient Relationship Enforced by Covid-19: Integrating Empathy in the Healthcare System

Abstract: The Covid-19 pandemic has posed a critical moral challenge for medical professionals due to its highly contagious nature that can cause severe respiratory disease and death. As a result, conventional doctor-patient relationships have collapsed since the pandemic. Patients and medical personnel are negatively impacted when social distancing is enforced due to concerns about viral transmission. How to provide high-quality services and maintain professional moral standards in such critical conditions is discussed in this paper, emphasizing empathy as a key moral virtue for professional practice. As moral philosophers offer and advance persuasive arguments, the definition of empathy has been examined to eliminate ambiguity and highlight the distinctions between emotion, passion, compassion, and sympathy. It has been argued that empathy gives medical professionals direction to take the proper perspective in a critical pandemic like Covid-19. Cases are discussed in relation to actual occurrences to argue the moral virtue of empathy and uphold professional standards in medical practices. Empathy can reduce malpractice claims significantly, increase patient satisfaction, and contribute to the good governance of healthcare service management.

Navigating the Service Ecosystem in Private Primary Care to Enhance Healthcare Accessibility Management

Objective - The concept of the service ecosystem is gaining recognition in the academic community of management scholars. In this context, the discussion revolves around service-dominant logic, where the focus shifts to the value derived from service and relationships in the broader ecosystem. Therefore, this study aimed to explore the phenomena of healthcare access and how to navigate the service ecosystem to enhance healthcare accessibility management. Methodology - The qualitative method was used with a case study design across two private primary care facilities in West Java. Results – The results showed that challenges related to healthcare access were prevalent in developing countries, including Indonesia. However, there was a significant potential for innovation to achieve improvements. The results underscored the crucial need for collaborative efforts from multiple sectors and critical stakeholders. Novelty - The novelty of this study lies in the adoption of an ecosystem perspective, accentuating the significance of value co-creation through collaborative efforts among interconnected actors. The results also contributed to a more comprehensive understanding of healthcare accessibility management in developing countries, offering insights that could inform strategies for fostering a more equitable and inclusive healthcare service management. Type of Paper: Empirical JEL Classification: I11, M15, D63, I12, I13 Keywords: Healthcare Access, Service Ecosystem, Value Co-Creation, Healthcare Services, Primary Care Reference to this paper should be made as follows: Rachmania, I.N; Yudoko, G; Basri, M.H; Akbar, J. (2023). Navigating the Service Ecosystem in Private Primary Care to Enhance Healthcare Accessibility Management, J. Mgt. Mkt. Review, 8(4), 158 – 165. https://doi.org/10.35609/jmmr.2023.8.4(6)

Health care services for older people in COVID-19 pandemic times – A Nordic comparison

Objective To explore the Nordic municipal health and care services’ ability to promote principal goals within care for older people during the COVID-19 pandemic. Design and setting Two surveys were conducted among managers of municipal health care services for older people in Denmark, Finland, Norway and Sweden; the first around 6 months into the pandemic (survey 1), and the second around 12 months later (survey 2). Data were analysed through descriptive statistics, and multiple regression (OLS). Subjects 1470 (survey 1, 2020) and 745 (survey 2, 2021) managers. 32% in home care, 51% in nursing homes, 17% combined. Results In all countries the pandemic seems to have had more negative impact on eldercare services’ ability to promote an active and social life, than on the ability to promote or enhance older people’s mental and physical health. The regression analysis indicates that different factors influence the ability to promote these goals. Managers within nursing homes reported reduced ability to promote mental and physical health and an active social life to a significantly lower degree than managers of home care. The effect of three prevention strategies (lock down, testing, and/or organisational change), were explored. Organisational change (reorganize staff and practice, restrict use of substitutes) tended to impact the units’ ability to promote a social life in a positive direction, while lock down (areas, buffets etc) tended to impact both the ability to promote mental/physical health and a social life in a negative direction. Conclusion Measures that can improve opportunities for an active and social life during a pandemic should have high priority, particularily within home care.

How can NHS trusts in England optimise strategies to improve the mental health and well-being of hospital doctors? The Care Under Pressure 3 (CUP3) realist evaluation study protocol

IntroductionThe growing incidence of mental ill health in doctors was a major issue in the UK and internationally, even prior to the COVID-19 pandemic. It has significant and far-reaching implications,...

Facilitators and Barriers of Integrated Care for Older Adults with Multimorbidity: A Descriptive Qualitative Study.

A lack of coordinated care leads to multiple adverse effects for older adults with multimorbidity, including high treatment burdens, adverse health outcomes, reduplicated healthcare service utilization, and catastrophic healthcare expenditure. To foster healthy aging, person-centered integrated care that is responsive to older adults has been proposed by the World Health Organization. The objective of this study was to identify factors that impact the successful implementation of integrated care for older adults with multimorbidity in China. From July 2022 to May 2023, 33 healthcare providers and managers involved in the delivery and management of healthcare services for older adults with multimorbidity were recruited from Zhejiang Province, China using purposeful and maximum variation sampling methods. Semi-structured, face-to-face in-depth interviews were conducted by the same interviewer in the participants' native Chinese language until data saturation was reached. Inductive thematic analysis was used to analyze the data, and then, themes were mapped onto six dimensions using the Rainbow Model of Integrated Care to allow for a comprehensive view of the study's findings. Eleven themes were generated as facilitators and barriers to integrated care for older adults with multimorbidity in China. These themes include (1) clinical integration: patient-centered care, (2) professional integration: interdisciplinary teams and training, (3) organizational integration: resources and accessibility, (4) system integration: community and funds, incentives, and health insurance, (5) functional integration: electronic health record systems, workforce, and guidelines, and (6) normative integration: shared mission. Guided by the Rainbow Model of Integrated Care, various factors at both micro, meso, and macro levels that impact the implementation of integrated care for older adults with multimorbidity in the Chinese context have been identified in this study. The strategies for future interventions and policies should focus on promoting facilitators and addressing barriers.